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At least 73 records · Page 4Linked to original sources
PubMed1992

Paresthesia of the inferior alveolar nerve following the extraction of the mandibular third molars: a literature review of its causes, treatment, and prognosis.

Mandibular paresthesia is an unfortunate complication after the extraction of mandibular third molars. Damage to the inferior alveolar nerve may occur via direct or indirect injury. Careful evaluation of pre-operative panoramic radiographs with regard to root configuration and intimacy to the mandibular canal are most important. Various surgical techniques may be dictated by the radiographic presentation. When paresthesia does occur, a simple yet thorough mechanism for documentation is required. This article reviews paresthesia of the inferior alveolar nerve as a result of the extraction of the mandibular third molars.

Humans↗
PubMedDate not supplied

Mandibular endodontic-related paresthesia.

A 57-year-old woman sought treatment for mandibular swelling (of two weeks duration), pain, and paresthesia in the region of the left canine and first premolar. The teeth had undergone endodontic therapy; in addition, they partially supported a long-span fixed partial denture. The patient was concerned about the possibility of a serious neoplastic condition. The initial panoramic radiograph demonstrated a large periapical pathology area associated with the first premolar. Eventually, both the canine and first premolar teeth were retreated, although the paresthesia did not resolve for approximately four months. A brief review of endodontic-associated paresthesia is provided, along with a description of the therapy and postoperative radiographs taken 20 months later.

Bicuspid↗
PubMed1999

The risk of persistent paresthesia is not increased with repeated axillary block.

UNLABELLED: Neurologic deficits are noted on physical examination in approximately 0.2%-19% of patients after regional anesthetic techniques. Laboratory and clinical studies suggest that a subclinical neuropathy occurs much more often. Performing a regional anesthetic technique during this period may result in additional nerve trauma. We evaluated the frequency of neurologic complications in patients undergoing repeated axillary block. A total of 1614 blocks were performed on 607 patients. The median number of blocks per patient was two (range 2-10 blocks). The median interval between blocks was 12.6 wk, including 188 (31%) patients who received multiple blocks within 1 wk. Sixty-two neurologic complications occurred in 51 patients for an overall frequency of 8.4%. Of the 62 nerve injuries, 7 (11.3%) were related to the anesthetic technique; the remaining 55 (88.7%) were a result of the surgical procedure. Patient age and gender, the presence of preexisting neurologic conditions, a surgical procedure to a nerve, and total number of blocks did not increase the risk of neurologic complications. No regional anesthetic technique risk factors, including elicitation of a paresthesia, selection of local anesthetic, or addition of epinephrine, were identified. The success rate was higher with the paresthesia technique than with nerve stimulator technique or transarterial injection, and with use of mepivacaine versus bupivacaine. We conclude that the frequency of neurologic complications in patients undergoing repeated axillary block is similar to that in patients receiving a single regional technique. These patients are not likely to be at increased risk of neurologic complications. IMPLICATIONS: The risk of neurologic complications was not increased in patients who underwent multiple axillary blocks, even within a 1-wk interval. No risk factors for anesthetic-related complications were identified. However, block success rate was increased with the paresthesia technique and the injection of mepivacaine versus bupivacaine.

Adrenergic Agonists↗
PubMed1998

[Comparison of transarterial technique and paresthesia technique of axillary brachial plexus block].

Axillary brachial plexus blocks were established in 40 patients using transarterial technique (n = 20) or paresthesia technique (n = 20). Sensory and motor blockades of nerves supplying the upper extremity were compared at 10, 20 and 30 minutes after the injection of local anesthetics (1.5% plain mepivacaine 40 ml). Sensory blockades of the radial nerve and axillary nerve were significantly higher with transarterial technique than paresthesia technique. The incidence of analgesia of the radial nerve at 30 min was 100% with transarterial technique and 70% with paresthesia technique. Sensory blockades of the other nerves and motor blockades of all nerves did not show any significant differences between the two techniques. Proximal and distal spreads of the local anesthetic-contrast medium mixture within the axillary neurovascular sheath were studied in 20 patients. No statistically significant difference was observed in the spread of contrast agent between the two techniques. Transarterial technique is a recommendable method for hand surgery and especially indicated for the surgery of the area supplied by the radial nerve.

Adult↗
PubMed1994

Further regional variants of acute immune polyneuropathy. Bifacial weakness or sixth nerve paresis with paresthesias, lumbar polyradiculopathy, and ataxia with pharyngeal-cervical-brachial weakness.

OBJECTIVE: To describe four syndromes of acute regional weakness with clinical, spinal fluid, and electrophysiologic similarities to the acute immune polyneuropathy of Guillain-Barré syndrome. DESIGN: Case series of personally examined patients. RESULTS: Seven patients are described: four with facial diplegia and distal limb paresthesias, one with sixth nerve palsy and distal paresthesias, one with bilateral lumbar polyradiculopathy, and one with combined Fisher's syndrome and pharyngeal-cervical-brachial weakness. These self-limited illnesses, which evolved over days or weeks, involved acellular cerebrospinal fluid with raised protein concentration and electrophysiologic findings that were consistent with a demyelinating polyneuropathy. CONCLUSIONS: The first three regional variants of Guillain-Barré syndrome may cause diagnostic difficulty, particularly at the onset of illness, and the fourth links Fisher's syndrome with the typical syndrome. The consistently bilateral weakness of Guillain-Barré syndrome and its regional variants and the absence of a monoparetic or hemiparetic pattern suggest that the pathologic process occurs in the same single or contiguous groups of nerves on both sides of the sagittal plane but is not randomly distributed in the peripheral nervous system.

Abducens Nerve↗
PubMed1993

Microneurography, impulse conduction, and paresthesias.

It is possible to learn more about peripheral nerve function in human subjects than is obtainable with routine nerve conduction studies, and thereby to study the basis of "positive" symptoms, such as paresthesias. Using microneurography, ectopic impulse activity in cutaneous afferents has been recorded in patients suffering from neurologic disorders and in normal subjects in whom paresthesias were provoked by hyperventilation, prolonged tetanization of cutaneous nerves and ischemia. Using relatively simple modifications of standard nerve conduction techniques, the increases in axonal excitability responsible for this ectopic activity have been documented in human volunteers. Hyperventilation increases axonal excitability but does not change supernormality, probably because Na+ channels are activated by the decrease in [Ca2+] on the axonal membrane. Prolonged tetanic stimulation and ischemia probably share similar mechanisms. At least in motor axons, postischemic ectopic activity occurs when the hyperpolarization that results from activation of the Na+/K+ pump lowers the membrane potential below the equilibrium potential for K+. A high extracellular [K+] can then result in an inward current producing depolarization and possibly triggering regenerative processes.

Axons↗
PubMed1978

Paresthesia from N2. Report of a case.

A number of cases of paresthesia following the use of N2 or other paraformaldehyde-containing root canal cements have been reported. Since paresthesia is longlasting and not only an inconvenience but also disabling at times, such cements should not be used for obturating root canals.

Female↗
PubMed1986

Mandibular paresthesia secondary to cerebrovascular changes.

An unusual case of mandibular paresthesia as the only presenting symptom of a cerebrovascular accident is presented. The differential diagnosis of inferior alveolar nerve paresthesia is discussed. Obtaining a definitive diagnosis depends on a thorough medical and dental history complemented by a complete clinical and radiographic examination. The etiology of cerebral vascular accidents is reviewed, as well as risk factors that may increase the possibility of a cerebrovascular accident.

Adult↗
PubMed1987

Flare-up with associated paresthesia of a mandibular second premolar with three root canals.

A case report is presented that deals with mental nerve paresthesia resulting from the "flare-up" of a mandibular second premolar with three root canals. A review of the literature and discussion follow, which suggest possible mechanisms that may be responsible for paresthesia as well as treatment regimens that may be used to minimize the incidence of this unexpected but occasional post-treatment endodontic sequela.

Adult↗
PubMedDate not supplied

Distribution of lumbar spinal evoked potentials and their correlation with stimulation-induced paresthesiae.

In 7 awake patients with neuropathic lower extremity pain, spinal somatosensory evoked potentials (SEP) were elicited from the non-painful leg by electrical stimulation of the peroneal nerve and mechanical stimulation of the hallux ball. Recording was made epidurally in the thoraco-lumbar region by means of an electrode temporarily inserted for trial of pain-suppressing stimulation. In response to peroneal nerve stimulation, two major SEP complexes were found. The first complex consisted, as has been described earlier, of an initial positivity (P12), a spike-like negativity (N14), a slow negativity (N16) and a slow positivity (P23). The second complex consisted of a slow biphasic wave, conceivably mediated by a supraspinal loop. Both complexes had a similar longitudinal distribution with amplitude maxima at the T12 vertebral body. The SEP evoked by mechanical hallux ball stimulation had a relatively small amplitude, and there was no significant second complex. The relationship between stimulus intensity and SEP amplitude was negatively accelerating. The longitudinal distribution of spinal SEP was compared with the somatotopic distribution of paresthesiae induced by stimulation through the epidural electrode. It was found that stimulation applied at the level of maximal SEP generally induced paresthesiae in the corresponding peripheral region. Therefore, spinal SEP may be used as a guide for optimal positioning of a spinal electrode for therapeutic stimulation when implanted under general anesthesia. An attempt was made to record the antidromic potential in the peroneal nerve elicited from the dorsal columns by epidural stimulation. The antidromic response was, however, very sensitive to minimal changes of stimulus strength and body position of the patient, and was also contaminated by simultaneously evoked muscular reflex potentials. Thus, peripheral responses evoked by epidural stimulation appeared too unreliable to be useful for the permanent implantation of a spinal electrode for therapeutic stimulation.

Adult↗
PubMed2006

Mental nerve paresthesia associated with endodontic paste within the mandibular canal: report of a case.

The present study describes a case of endodontic paste (Endomethasone) penetration within and along the mandibular canal from the periapical zone of a lower first premolar following endodontic treatment of the latter. The clinical manifestations comprised anesthesia of the right side of the lower lip and paresthesia of the gums in the fourth quadrant, appearing immediately after endodontic treatment. The lip anesthesia was seen to decrease, with persistence of the gingival paresthesia, after 7 months.

Adult↗
PubMed1998

Tactile, thermal and pain sensibility in burned patients with and without chronic pain and paresthesia problems.

Abnormal return of cutaneous sensibility is common after burn injuries and many patients complain of painful and/or paresthetic sensations in their healed wounds. However, little is known about the exact nature and severity of these problems. The present study was designed to provide a quantitative evaluation of the cutaneous sensibility in burned patients. Tactile, thermal and pain thresholds were measured in 121 patients with healed burns paired-matched to 121 control healthy subjects more than 18 months after the burns. Testing was confined to both upper limbs and was performed in a healed burn area and its contralateral burned or unburned counterpart. The tested sites were also divided into symptomatic and asymptomatic ones, depending on the presence or not of pain or paresthesia at the site. The results showed significantly higher sensory thresholds in burned patients than control subjects. Severity of the deficits of the various sensory modalities was, however, a function of burn depth. Deep burn injuries which had required skin grafts to heal were more seriously affected than superficial burns which had healed spontaneously. Significant sensory losses were found not only in burn sites but also in the non-injured areas suggesting changes in the central nervous system. When symptomatic and asymptomatic sites were compared, significant deficits were observed in the tactile modality (touch-pressure). Other significant predictors of chronic sensory problems were burn depth and patients' age. Pathophysiological mechanisms of diminished sensibility in burned and unburned skin as long as several years after the injury are discussed along with those implicated in pain and paresthesia problems reported by the patients.

Adolescent↗
PubMed2006

Mental paresthesia and orthodontic treatment.

This article reports a case of mental paresthesia during orthodontic treatment. It also discusses which cases may be at risk for developing mental paresthesia and its prevention and management.

Adult↗
PubMed2000

Paresthesia of the mental nerve induced by periapical infection: a case report.

Paresthesia can be a rare complication of infections of dental origin. This article presents a case of anesthesia/paresthesia caused by a periapical infection of the right mandibular second premolar. The sensory disturbance disappeared 2 weeks after conventional endodontic treatment associated with antibiotic therapy. Twelve months later, the tooth was still asymptomatic. The possible mechanisms responsible for paresthesia associated with periapical infection are discussed.

Chin↗
PubMed1995

Cold saline is more effective than room temperature saline in inducing paresthesia during axillary block.

Confirmation of the perivascular position of the needle by the injection of cold saline may be helpful to the perivascular technique, since the elicitation of a paresthesia indicates the correct positioning of the needle. In this prospective, randomized study of 48 patients, we found a 100% incidence of successful block with saline at 8-11 degrees C compared to 75% in a control group with saline at room temperature. The paresthesia induced by cold saline appears to be due to thermic stimulation and not to mechanical nerve compression by the saline entering the axillary space. A more frequent rate of correct positioning of the needle was found in the group with cold saline.

Axilla↗
PubMed1984

Inhibition of cutaneous paresthesia resulting from synthetic pyrethroid exposure.

Synthetic pyrethroids are potent lipophilic insecticides recognized as nerve toxins. Their increased usage in recent years has established them as a serious competitor against the currently available pesticides. Reported cases of occupational exposure have noted the presence of paresthesia without the clinical symptoms of erythema, edema, or vesiculation. Pilot studies were performed with six prophylactic agents to assess their capability of preventing or ameliorating the paresthesia that accompanies exposure. Vitamin E oil (dl-alpha tocopheryl acetate) proved the most efficacious.

Butylated Hydroxyanisole↗
PubMed1989

Somatosensory evoked potentials in the evaluation of patients with stocking/glove paresthesias.

We studied 10 patients referred for suspicion of peripheral neuropathy. They all complained of paresthesias with a stocking distribution. As EMG, motor and sensory nerve conduction studies failed to confirm the clinical diagnosis, we studied somatosensory evoked potentials (SEP) following median and tibial nerve stimulation. The SEP findings were compared with controls and 10 spastic paraplegias. The evoked potential study revealed prolonged latencies of cortical potentials after tibial nerve stimulation in all the patients with paresthesias and were considered evidence of myelopathy.

Adult↗